title: The cost-effectiveness of shopping to a predetermined grocery list to reduce overweight and obesity.
abstract: BACKGROUND
  Pre-commitment strategies can encourage participants to commit to a healthy food plan and have been suggested as a potential strategy for weight loss. However, it is unclear whether such strategies are cost-effective.
  
  
  OBJECTIVE
  To analyse whether pre-commitment interventions that facilitate healthier diets are a cost-effective approach to tackle obesity.
  
  
  METHODS
  Effectiveness evidence was obtained from a systematic review of the literature. For interventions demonstrating a clinically significant change in weight, a Markov model was employed to simulate the long-term health and economic consequences. The review supported modelling just one intervention: grocery shopping to a predetermined list combined with standard behavioural therapy (SBT). SBT alone and do nothing were used as comparators. The target population was overweight or obese adult women. A lifetime horizon for health effects (expressed as quality-adjusted life years (QALYs)) and costs from the perspective of the UK health sector were used to calculate incremental cost-effectiveness ratios (ICERs).
  
  
  RESULTS
  In the base case analysis, the pre-commitment strategy of shopping to a list was found to be more effective and cost saving when compared against SBT, and cost-effective when compared against 'do nothing' (ICER=£166 per QALY gained). A sensitivity analysis indicated that shopping to a list remained dominant or cost-effective under various scenarios.
  
  
  CONCLUSIONS
  Our findings suggest grocery shopping to a predetermined list combined with SBT is a cost-effective means for reducing obesity and its related health conditions.
authors.affiliation: Centre for Health Economics, Monash University, Melbourne, Victoria, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Au
authors.forename: G
authors.initials: G
authors.lastname: Marsden
authors.forename: D
authors.initials: D
authors.lastname: Mortimer
authors.forename: P K
authors.initials: PK
authors.lastname: Lorgelly